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NPI Code Detail

MEDICARE: DENTAL EXPERTS, LLC

MEDICARE: DENTAL EXPERTS, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryIL

General Provider Information

NPI Number : 1962673954
Entity Type Code : Organization
Provider Name (Legal Business Name) : DENTAL EXPERTS, LLC
Provider Business Mailing Address
First Line : 4039 W NORTH AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60639-5219
Country : US
Telephone Number : 773-782-4800
Fax Number :
Provider Business Practice Location Address
First Line : 4039 W NORTH AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60639-5219
Country : US
Telephone Number : 773-782-4800
Fax Number :
Authorized Official
Title or Position : OWNER/DENTIST
Name : SAMEERA HUSSAIN
Credential : DMD
Telephone Number : 630-750-1405
Provider Enumeration Date : 03/18/2008
Last Update Date : 03/18/2008

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Directions to “DENTAL EXPERTS, LLC ” Practice Location

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